Evidence map›Paper›PMID 38488970›Full record

ArticleEuropean radiology2024

Paris classification of colonic polyps using CT colonography: prospective cohort study of interobserver variation.

Anmol Gangi-Burton, Andrew A Plumb, Katja N De Paepe, Edmund M Godfrey, Steve Halligan, Antony Higginson, Samir Khwaja, Anisha Patel, Stuart Taylor

Abstract read
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In one paragraph

Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 2 countries.

Anmol Gangi-BurtonNottingham University Hospitals NHS Trust, Nottingham, UK.
Andrew A PlumbUniversity College London Hospitals NHS Foundation Trust, London, UK. andrew.plumb@nhs.net.ORCID http://orcid.org/0000-0003-1322-5113
Katja N De PaepeAddenbrooke's Hospital, Cambridge, UK.
Edmund M GodfreyAddenbrooke's Hospital, Cambridge, UK.
Steve HalliganCentre for Medical Imaging, University College London, London, UK.
Antony HigginsonQueen Alexandra Hospital, Portsmouth, UK.
Samir KhwajaAddenbrooke's Hospital, Cambridge, UK.
Anisha PatelUniversity College London Hospitals NHS Foundation Trust, London, UK.
Stuart TaylorCentre for Medical Imaging, University College London, London, UK.
Addenbrooke's Hospital · GBUniversity College London · GBUniversity College London Hospitals NHS Foundation Trust · GBBeth Israel Deaconess Medical Center · USNottingham University Hospitals NHS Trust · GBQueen Alexandra Hospital · GB

Funding

British Society of Gastrointestinal and Abdominal Radiology Education Bursary 2019
6 · The paper itself

Abstract

backgroundThe Paris classification categorises colorectal polyp morphology. Interobserver agreement for Paris classification has been assessed at optical colonoscopy (OC) but not CT colonography (CTC). We aimed to determine the following: (1) interobserver agreement for the Paris classification using CTC between radiologists; (2) if radiologist experience influenced classification, gross polyp morphology, or polyp size; and (3) the extent to which radiologist classifications agreed with (a) colonoscopy and (b) a combined reference standard.

methodsFollowing ethical approval for this non-randomised prospective cohort study, seven radiologists from three hospitals classified 52 colonic polyps using the Paris system. We calculated interobserver agreement using Fleiss kappa and mean pairwise agreement (MPA). Absolute agreement was calculated between radiologists; between CTC and OC; and between CTC and a combined reference standard using all available imaging, colonoscopic, and histopathological data.

resultsOverall interobserver agreement between the seven readers was fair (Fleiss kappa 0.33; 95% CI 0.30-0.37; MPA 49.7%). Readers with < 1500 CTC experience had higher interobserver agreement (0.42 (95% CI 0.35-0.48) vs. 0.33 (95% CI 0.25-0.42)) and MPA (69.2% vs 50.6%) than readers with ≥ 1500 experience. There was substantial overall agreement for flat vs protuberant polyps (0.62 (95% CI 0.56-0.68)) with a MPA of 87.9%. Agreement between CTC and OC classifications was only 44%, and CTC agreement with the combined reference standard was 56%.

conclusionRadiologist agreement when using the Paris classification at CT colonography is low, and radiologist classification agrees poorly with colonoscopy. Using the full Paris classification in routine CTC reporting is of questionable value. CLINICAL RELEVANCE STATEMENT: Interobserver agreement for radiologists using the Paris classification to categorise colorectal polyp morphology is only fair; routine use of the full Paris classification at CT colonography is questionable. KEY POINTS: • Overall interobserver agreement for the Paris classification at CT colonography (CTC) was only fair, and lower than for colonoscopy. • Agreement was higher for radiologists with < 1500 CTC experience and for larger polyps. There was substantial agreement when classifying polyps as protuberant vs flat. • Agreement between CTC and colonoscopic polyp classification was low (44%).

Indexed as

Colonic PolypsColonography, Computed TomographicObserver VariationAdultAgedColonoscopyFemaleHumansMaleMiddle AgedProspective StudiesColonic polypsColonoscopyObserver variationRadiologists

Identifiers

PMID38488970
OpenAlexW4392865016

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.